TY - JOUR
T1 - LONG-HOSP Score
T2 - A Novel Predictive Score for Length of Hospital Stay in Acute Lower Gastrointestinal Bleeding-A Multicenter Nationwide Study
AU - Fujita, Minoru
AU - Aoki, Tomonori
AU - Manabe, Noriaki
AU - Ito, Yoichiro
AU - Kobayashi, Katsumasa
AU - Yamauchi, Atsushi
AU - Yamada, Atsuo
AU - Omori, Jun
AU - Ikeya, Takashi
AU - Aoyama, Taiki
AU - Tominaga, Naoyuki
AU - Sato, Yoshinori
AU - Kishino, Takaaki
AU - Ishii, Naoki
AU - Sawada, Tsunaki
AU - Murata, Masaki
AU - Takao, Akinari
AU - Mizukami, Kazuhiro
AU - Kinjo, Ken
AU - Fujimori, Shunji
AU - Uotani, Takahiro
AU - Sato, Hiroki
AU - Suzuki, Sho
AU - Narasaka, Toshiaki
AU - Hayasaka, Junnosuke
AU - Funabiki, Tomohiro
AU - Kinjo, Yuzuru
AU - Mizuki, Akira
AU - Kiyotoki, Shu
AU - Mikami, Tatsuya
AU - Gushima, Ryosuke
AU - Fujii, Hiroyuki
AU - Fuyuno, Yuta
AU - Gunji, Naohiko
AU - Toya, Yosuke
AU - Narimatsu, Kazuyuki
AU - Nagaike, Koji
AU - Kinjo, Tetsu
AU - Sumida, Yorinobu
AU - Funakoshi, Sadahiro
AU - Kobayashi, Kiyonori
AU - Matsuhashi, Tamotsu
AU - Komaki, Yuga
AU - Miki, Kuniko
AU - Watanabe, Kazuhiro
AU - Ayaki, Maki
AU - Murao, Takahisa
AU - Suehiro, Mitsuhiko
AU - Shiotani, Akiko
AU - Hata, Jiro
AU - Haruma, Ken
AU - Kaise, Mitsuru
AU - Nagata, Naoyoshi
AU - Nagata, Naoyoshi
N1 - Publisher Copyright:
© 2023 S. Karger AG. All rights reserved.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Introduction: Length of stay (LOS) in hospital affects cost, patient quality of life, and hospital management; however, existing gastrointestinal bleeding models applicable at hospital admission have not focused on LOS. We aimed to construct a predictive model for LOS in acute lower gastrointestinal bleeding (ALGIB). Methods: We retrospectively analyzed the records of 8,547 patients emergently hospitalized for ALGIB at 49 hospitals (the CODE BLUE-J Study). A predictive model for prolonged hospital stay was developed using the baseline characteristics of 7,107 patients and externally validated in 1,440 patients. Furthermore, a multivariate analysis assessed the impact of additional variables during hospitalization on LOS. Results: Focusing on baseline characteristics, a predictive model for prolonged hospital stay was developed, the LONG-HOSP score, which consisted of low body mass index, laboratory data, old age, nondrinker status, nonsteroidal anti-inflammatory drug use, facility with ≥800 beds, heart rate, oral antithrombotic agent use, symptoms, systolic blood pressure, performance status, and past medical history. The score showed relatively high performance in predicting prolonged hospital stay and high hospitalization costs (area under the curve: 0.70 and 0.73 for derivation, respectively, and 0.66 and 0.71 for external validation, respectively). Next, we focused on in-hospital management. Diagnosis of colitis or colorectal cancer, rebleeding, and the need for blood transfusion, interventional radiology, and surgery prolonged LOS, regardless of the LONG-HOSP score. By contrast, early colonoscopy and endoscopic treatment shortened LOS. Conclusions: At hospital admission for ALGIB, our novel predictive model stratified patients by their risk of prolonged hospital stay. During hospitalization, early colonoscopy and endoscopic treatment shortened LOS.
AB - Introduction: Length of stay (LOS) in hospital affects cost, patient quality of life, and hospital management; however, existing gastrointestinal bleeding models applicable at hospital admission have not focused on LOS. We aimed to construct a predictive model for LOS in acute lower gastrointestinal bleeding (ALGIB). Methods: We retrospectively analyzed the records of 8,547 patients emergently hospitalized for ALGIB at 49 hospitals (the CODE BLUE-J Study). A predictive model for prolonged hospital stay was developed using the baseline characteristics of 7,107 patients and externally validated in 1,440 patients. Furthermore, a multivariate analysis assessed the impact of additional variables during hospitalization on LOS. Results: Focusing on baseline characteristics, a predictive model for prolonged hospital stay was developed, the LONG-HOSP score, which consisted of low body mass index, laboratory data, old age, nondrinker status, nonsteroidal anti-inflammatory drug use, facility with ≥800 beds, heart rate, oral antithrombotic agent use, symptoms, systolic blood pressure, performance status, and past medical history. The score showed relatively high performance in predicting prolonged hospital stay and high hospitalization costs (area under the curve: 0.70 and 0.73 for derivation, respectively, and 0.66 and 0.71 for external validation, respectively). Next, we focused on in-hospital management. Diagnosis of colitis or colorectal cancer, rebleeding, and the need for blood transfusion, interventional radiology, and surgery prolonged LOS, regardless of the LONG-HOSP score. By contrast, early colonoscopy and endoscopic treatment shortened LOS. Conclusions: At hospital admission for ALGIB, our novel predictive model stratified patients by their risk of prolonged hospital stay. During hospitalization, early colonoscopy and endoscopic treatment shortened LOS.
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U2 - 10.1159/000531646
DO - 10.1159/000531646
M3 - Article
C2 - 37536306
AN - SCOPUS:85179005685
SN - 0012-2823
VL - 104
SP - 446
EP - 459
JO - Digestion
JF - Digestion
IS - 6
ER -